EP3799809A1 - Reciprocating drive system for a cutting device - Google Patents
Reciprocating drive system for a cutting device Download PDFInfo
- Publication number
- EP3799809A1 EP3799809A1 EP20199924.0A EP20199924A EP3799809A1 EP 3799809 A1 EP3799809 A1 EP 3799809A1 EP 20199924 A EP20199924 A EP 20199924A EP 3799809 A1 EP3799809 A1 EP 3799809A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- shaft member
- follower
- helical
- housing
- recess
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320028—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments with reciprocating movements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320032—Details of the rotating or oscillating shaft, e.g. using a flexible shaft
Definitions
- the present disclosure relates generally to cutting devices and apparatus used during surgical procedures.
- arthroscopic, or keyhole procedures require the use of a surgical cutting instrument that can be inserted into, and cut tissue within, a small incision relative to open procedures.
- Such cutting instruments utilize a reciprocating drive system to drive a variety of reciprocating or rotating cutting members to cut or resect tissue.
- Surgical cutting instruments suitable for use in open procedures, arthroscopic procedures, ear, nose, and throat (ENT) debridement, or keyhole procedures can utilize various types of cutting systems to cut or resect tissue.
- a typical cutting instrument includes a cutting member comprised of a stationary outer tube and a translatable inner tube. Tissue enters an opening in the outer tube and is cut by shear force between the translatable inner tube and the stationary outer tube.
- Various drive systems exist to drive the cutting member. Generally, such systems include a drive member that is configured to follow a pre-formed drive path to drive the cutting member.
- existing drive systems typically require numerous components, which can increase the cost of production and reduce the reliability of the drive system.
- existing systems utilize a drive path formed by a series of threads on a component separate from an external housing.
- relatively strong or dense tissue must be cut.
- the drive system must be robust to apply sufficient force to cut the tissue.
- Existing drive systems utilize a single drive member to follow the drive path. The force required can cause the single follower to break, or to skip over threads within the drive path, resulting in drive system malfunction or failure.
- a reciprocating drive system for a surgical cutting device can include a housing defining one or more helical threads on an inner surface.
- the helical threads can form a drive path for one or more followers to follow and correspondingly translate a reciprocating cutting member to cut tissue.
- the formation of the helical threads on the housing can reduce the number of parts required, by eliminating the need for two separate components to provide the functions of an external housing and a drive path. Reducing the number of parts required can improve the reliability and reduce the cost of production of a reciprocating drive system suitable for arthroscopic use.
- the reciprocating drive system can include two or more followers to increase the force the cutting member can apply and further improve the reliability of the reciprocating drive system.
- FIG. 1A illustrates a cross-section of the reciprocating drive system 100 positioned within a handle of a surgical instrument 102, in accordance with at least one example of the present application.
- FIG. 1B illustrates a schematic view of the reciprocating drive system 100, in accordance with at least one example of the present application. Also shown in FIGS. 1A and 1B is a central axis A1, and orientation indicators Proximal and Distal. FIGS. 1A and 1B are discussed below concurrently.
- the reciprocating drive system 100 can be positioned within a surgical instrument 102.
- the reciprocating drive system 100 can provide reciprocating drive to the surgical instrument 102.
- the surgical instrument 102 can be, for example, a motor-assisted arthroscopic cutting device.
- the surgical instrument 102 can also be a variety of other surgical cutting devices that utilize a reciprocating or a rotating cutting member.
- the surgical instrument 102 can include an instrument handle 104.
- the instrument handle 104 can include a proximal portion 106 and a distal portion 108.
- the proximal portion 106 and the distal portion 108 can be proximal and distal portions, respectively, of the instrument handle 104.
- the reciprocating drive system 100 can be positioned in various positions within the instrument handle 104, generally between the proximal portion 106 and the distal portion 108.
- the surgical instrument 102 can include a cutting member 110 and an outer tube 112.
- the cutting member 110 can be a cylindrical tube configured to be positionable and translatable within the outer tube 112.
- the cutting member 110 can be coupled to, and extend distally from, the reciprocating drive system 100.
- the outer tube 112 can be a cylindrical tube configured to accept the cutting member 110.
- the cutting member 110 and the outer tube 112 can be fixedly coupled to, and extend distally from the reciprocating drive system 100, or the instrument handle 104.
- the cutting member 110 can include a cutting window 114.
- the cutting window 114 can be an opening formed in a generally distal potion of the cutting member 110.
- the cutting window 114 can have a pair of cutting teeth.
- the outer tube 112 can include an opening 116.
- the opening 116 can be an opening formed in a generally distal portion of the outer tube 112.
- the opening 116 can have a pair of cutting teeth.
- the cutting window 114 can be driven to reciprocate past the opening 116 to cut tissue.
- the cutting member 110 and the outer tube 112 can be reusable and fixedly coupled to the instrument handle 104.
- the reciprocating drive system 100, the cutting member 110, the outer tube 112, or any combination thereof can be disposable and detachably coupled to the instrument handle 104.
- the reciprocating drive system 100, the cutting member 110, and the outer tube 112 can also be configured to be used with various existing motorized handles, such as the instrument handle 104.
- the reciprocating drive system 100 can be operable to translate the cutting member 110 proximally and distally along the central axis A1, to cut or resect tissue via reciprocating motion.
- the surgical instrument 102 can include a driveshaft 117.
- the driveshaft 117 can extend within the instrument handle 104 along the central axis A1.
- the driveshaft 117 can extend within the instrument handle 104 between the proximal portion 106 and the distal portion 108.
- the driveshaft 117 can be coupled to the reciprocating drive system 100.
- the driveshaft 117 can extend into the reciprocating drive system 100 through a drive opening 119 formed in a generally proximal end of the reciprocating drive system 100.
- the driveshaft 117 can also be cannulated, or can otherwise define a bore extending longitudinally through the driveshaft 117 along the central axis A1.
- the instrument handle 104 can include a motive source 118.
- the motive source 118 can be, but is not limited to, an electrically or pneumatically actuated motor.
- the motive source 118 can include a cannulated shaft 121.
- the cannulated shaft 121 can extend along the central axis A1, coaxially with the driveshaft 117.
- the coaxial shaft configuration of the reciprocating drive system 100 and the instrument handle 104 can be simpler and more compact relative to, for example, a drive system including a vertically offset motive source.
- some devices involving reciprocating and rotary motion utilize a three-shaft system with an offset motor in order to provide the requisite forms of motion.
- a proximal portion of the cannulated shaft 121 can be coupled to the driveshaft 117, and a distal portion of the cannulated shaft 121 can be coupled a suction pump 123, via a suction tube 125.
- the suction pump 123 can thereby apply suction through the suction tube 125, the cannulated shaft 121, and the driveshaft 117, to facilitate transfer of fluid through the surgical instrument 102, such as to help extract tissues or other surgical debris from the reciprocating drive system 100 or to deliver irrigation fluid.
- the reciprocating drive system 100, the cutting member 110, and the outer tube 112 can be removed from the instrument handle 104 and discarded. This can improve the ease and quality of sterilization of the surgical instrument 102 between surgical procedures.
- the reciprocating drive system 100 can thereby help perform one or more operations of a surgical procedure.
- FIG. 2 illustrates an exploded view of the reciprocating drive system 100, in accordance with at least one example of the present application. Also shown in FIG. 2 is a central axis A1, and orientation indicators Proximal and Distal.
- the reciprocating drive system 100 can include a housing 120 having the drive opening 119, a proximal portion 122, a distal portion 124, a first portion 126, a second portion 128, an inner surface 130, helical threads 132, a non-threaded portion 134, a shaft member 136, an outer surface 138, flanges 140, flange protrusions 141, flange recesses 143, a proximal portion 142, a distal portion 144, a first follower 146, a second follower 148, a first recess 150, a second recess 152, a projection 154, and a bore 156.
- the housing 120 can define a central axis A1.
- the proximal portion 122 and the distal portion 124 can be proximal and distal portions, respectively, of the housing 120.
- the terms proximal and distal portion as used herein can be relative to an orientation as held by a surgeon during a surgical procedure.
- the housing 120 can be formed as single piece.
- the housing 120 can also be formed from multiple pieces.
- the first portion 126 and the second portion 128 can be separate pieces that can together form the housing 120.
- the housing 120 can include the inner surface 130.
- the inner surface 130 can be comprised of an inner surface of both the first portion 126 and the second portion 128.
- the inner surface 130 can form a generally cylindrical shape.
- the inner surface 130 can include and define the helical threads 132.
- the helical threads 132 can extend along the inner surface 130 of the housing 120, between the proximal portion 122 and the distal portion 124.
- the inner surface 130 of the housing 120 can also include the non-threaded portion 134.
- the non-threaded portion 134 can be positioned at the distal portion 124 of the housing 120.
- the non-threaded portion 134 can be configured to engage the shaft member 136 to position the shaft member 136 along the central axis A1, within the housing 120.
- the shaft member 136 can extend within the housing 120 between the proximal portion 122 and the distal portion 124.
- non-threaded portion 134 can also function as a bearing surface for the shaft member 136.
- second portion 128 can include an inner surface configured as a mirror image of the inner surface 130 such that the helical threads 132 mate with matching helical threads to form one or more double-helical thread paths along the housing 120.
- the housing 120 can include the outer surface 138.
- the outer surface 138 can be comprised of an outer surface of both the first portion 126 and the second portion 128.
- the outer surface 138 of the housing 120 can form a generally cylindrical shape.
- the outer surface 138 can also form a generally rectangular, or other three-dimensional shape.
- the outer surface 138 of the housing 120 can include the flanges 140.
- the flanges 140 can be protrusions extending radially outward from generally opposite sides of the outer surface 138 of housing 120.
- the flanges 140 can extend along the outer surface 138 of the housing 120 between the proximal portion 122 and the distal portion 124.
- the flanges 140 on the first portion 126 of the housing 120 can have different dimensions or geometries to the flanges 140 on the second portion 128 of the housing 120.
- the flanges 140 of the first portion 126 can include the flange protrusions 141
- the flanges 140 of the second portion 128 can include the flange recesses 143.
- the flange protrusions 141 can be configured to engage the flange recesses 143, to couple the first portion 126 of the housing 120 to the second portion 128 of the housing 120.
- the flanges 140 can thereby allow the first portion 126 and the second portion 128 to resists separation due to rotational, lateral, or other operational forces generated during use.
- the flanges 140 can help to orient and position the housing 120 within the surgical instrument.
- the proximal portion 142 and the distal portion 144 can be proximal and distal portions, respectively, of the shaft member 136.
- the proximal portion 142 of the shaft member 136 can extend within the proximal portion 122 of the housing 120.
- the distal portion 144 of the shaft member 136 can extend within the distal portion 124 of the housing 120.
- the distal portion 144 of the shaft member 136 can also extend distally beyond the distal portion 124 of the housing 120.
- the shaft member 136 can include the first follower 146.
- the shaft member 136 can also optionally include the second follower 148.
- the first follower 146 and the second follower 148 can extend radially outward from the shaft member 136.
- the first follower 146 and the second follower 148 can be positioned in various orientations along the shaft member 136.
- the first follower 146 and the second follower 148 can be shaped to correspond to the helical threads 132 formed in the housing 120.
- the first follower 146 and the second follower 148 can be configured to correspondingly engage and follow the helical threads 132.
- the first follower 146 and the second follower 148 can be interchangeable to reduce the number of different parts needed for manufacture of the reciprocating drive system 100.
- the shaft member 136 can include the first recess 150 and the second recess 152.
- the first recess 150 and the second recess 152 can be formed in the shaft member 136.
- the first recess 150 and the second recess 152 can be configured to accept and retain the first follower 146 and the second follower 148, respectively.
- the first recess 150 and the first follower 146 can be sufficiently similar in shape and size to the second recess 152 and the second follower 148, to allow the first follower 146 to be positioned within the second recess 152, and the second follower 148 to be positioned within the first recess 150.
- the first recess 150 and the second recess 152 can be configured to position the first follower 146 and the second follower 148 to engage the helical threads 132.
- the first recess 150 and the second recess 152 can thereby help to maintain alignment of the shaft member 136 with the central axis A1 when the shaft member 136 rotates.
- the shaft member 136 can include the projection 154.
- the projection 154 can extend radially outward from the distal portion 144 of the shaft member 136.
- the projection 154 can be positioned distally to the distal portion 124 of the housing 120.
- the projection 154 can extend radially outward beyond an external width, or a height, of the distal portion 124 of the housing 120.
- the projection 154 can be coupled to or formed on the distal portion 144 of the shaft member 136, in a position sufficiently distal to the housing 120, to allow the projection 154 to rotate and reciprocate proximally and distally along the central axis A1, when the shaft member 136 rotates.
- the projection 154 can thereby provide convenient access to the distal portion 144 of the shaft member 136 to manually apply rotational, and correspondingly, reciprocating movement to the shaft member 136, when at least the proximal portion 142 of shaft member 136 is disposed within the housing 120.
- the shaft member 136 can include the bore 156.
- the bore 156 can extend within the shaft member 136 between the proximal portion 142 and the distal portion 144.
- the bore 156 can be configured to accept and engage a driveshaft, such as the driveshaft 117 shown in FIG. 1 .
- the driveshaft 117 can extend through the drive opening 119 formed in the second portion 128 of the housing 120, to engage the bore 156 of the shaft member 136.
- the bore 156 can function as a motive coupler when engaging a driveshaft coupled to a motive source, such as the driveshaft 117.
- the housing 120, the proximal portion 122, the distal portion 124, the first portion 126, the second portion 128, the inner surface 130, the helical threads 132, the non-threaded portion 134, the shaft member 136, the outer surface 138, the flanges 140, the proximal portion 142, the distal portion 144, the first follower 146, the second follower 148, the first recess 150, the second recess 152, the projection 154, and the bore 156 can each be made from, but not limited to, plastic.
- the components listed above can be made from ABS plastic.
- the housing 120, the proximal portion 122, the distal portion 124, the first portion 126, the second portion 128, the inner surface 130, the helical threads 132, the non-threaded portion 134, the shaft member 136, the outer surface 138, the flanges 140, the proximal portion 142, the distal portion 144, the first follower 146, the second follower 148, the first recess 150, the second recess 152, the projection 154, and the bore 156 can also be made from stainless steel, or other metals via machining or metallic molding.
- the first follower 146 and the second follower 148 can be driven proximally and distally along the helical threads 132 to thereby reciprocate the shaft member 136, while the housing 120 is held in a stationary position within the instrument handle 104 ( FIG. 1 ) by the flanges 140.
- the single-directional continuous rotation provided by the motive source 118 to the shaft member 136, whether clockwise or counter-clockwise, can result in reciprocation of the shaft member 136.
- the shaft member 136 can be configured to slide over the driveshaft 117 to allow for both transmission of rotary input to the shaft member 136, and reciprocation of the shaft member 136.
- the transmission of rotary input to the shaft member 136, and associated reciprocation of the cutting member 110, with or without rotation, can be achieved using a variety of arrangements including couplers, bearings, clutches and the like.
- the driveshaft 117 can include a male key or male splines configured to mate into a female key or female splines formed in the shaft member 136, to transfer rotary input from the driveshaft 117 to the shaft member 136 while allowing reciprocation along the central axis A1, within a longitudinal length of the key or the splines.
- FIG. 3 illustrates a schematic view of the reciprocating drive system 100, in accordance with at least one example of the present application. Also shown in FIG. 3 is a central axis A1, and orientation indicators Proximal and Distal.
- the first follower 146 can be positioned within and extend radially outward from the first recess 150 of the shaft member 136.
- the second follower 148 can engage and extend radially outward from the second recess 152 of the shaft member 136.
- the first follower 146 and the second follower 148 can be configured to correspondingly engage the helical threads 132.
- the first follower 146 and the second follower 148 can follow the helical threads 132 to laterally translate the shaft member 136 along the central axis A1.
- the shaft member 136 can receive and transfer torque from a motive source to rotate the shaft member 136 within the housing 120.
- the reciprocating cutting system can include the projection 154.
- the projection 154 can allow a user to manually rotate the shaft member 136 from a position external to the housing 120, to manually reciprocate the shaft member 136 proximally and distally along the central axis A1.
- the first follower 146 and the first recess 150 can be laterally spaced apart from the second follower 148 and the second recess 152 along the shaft member 136.
- the first follower 146 and the first recess 150 can be positioned at the proximal portion 142 of the shaft member 136 and the second follower 148 and the second recess 152 can be centrally located on the shaft member 136, generally halfway between the proximal portion 142 and the distal portion 144.
- the first recess 150 and the second recess 152 can be formed in various other positions on the shaft member 136 generally between the proximal portion 142 and the distal portion 144.
- the position of the first recess 150 and the second recess 152, and correspondingly, the first follower 146 and the second follower 148, can dictate the distance the shaft member 136 travels laterally within the housing 120.
- the stroke length of a reciprocating cutting member can thereby be optimized for various surgical procedures based upon the lateral positioning of the first recess 150 and the second recess 152 on the shaft member 136.
- first recess 150 and the second recess 152 can be formed circumferentially offset positions relative to each other on the shaft member 136.
- the second recess 152 can be positioned 180 degrees offset relative to the first recess 150.
- the second recess 152 can also be offset, 45, 90, 135, 225, or 270 degrees offset relative to the first recess 150.
- the circumferential offset of the first follower 146 relative to the second follower 148 can improve the axial alignment of the shaft member 136 within the non-threaded portion 134 of the housing 120 to prevent binding of the first follower 146 and the second follower 148 within the helical threads 132.
- the circumferential offset of the first follower 146 relative to the second follower 148 can thereby provide smoother operation of the reciprocating drive system 100, particularly when dense or tough tissues are to be cut.
- the helical threads 132 can define a bi-directional helical path for the first follower 146 and the second follower 148 to follow.
- first follower 146 or the second follower 148 reaches a proximal or a distal end of the helical threads 132
- the first 146 or the second 148 followers can reverse direction and follow the helical threads 132 back in the opposite direction.
- the helical threads 132 can thereby allow the shaft member 136 to reciprocate through cyclical proximal and distal translation when the shaft member 136 rotates either clockwise or counterclockwise.
- the helical threads 132 can provide two separate thread paths for the first follower 146 and the second follower 148 to follow, respectively.
- FIG. 4 illustrates a schematic view of the housing 120, in accordance with at least one example of the present application. Also shown in FIG. 4 is a central axis A1, and orientation indicators Proximal and Distal.
- the reciprocating cutting device 100 can include a first series of threads 158, a second series of threads, and transitional surfaces 162.
- the helical threads 132 can extend along the inner surface 130 of the housing 120, generally from between the proximal portion 122 and the non-threaded portion 134 at the distal portion 124. A portion of the inner surface 130 of the housing at the proximal portion 122 can also be non-threaded.
- the helical threads 132 can define a single directional helical path or a bi-directional helical path.
- the helical threads 132 can include a first thread 158 and a second thread 160.
- the first thread 158 can be a first helical thread formed at a first orientation on the inner surface 130 of the housing 120.
- the second thread 160 can be a second thread formed at a second orientation on the inner surface 130 of the housing 120.
- the second thread 160 can be formed at different orientation relative to the first thread 158.
- the first thread 158 can be a right-handed thread and the second thread 160 can be a left-handed thread, or vice versa.
- the first thread 158 and the second thread 160 can intersect to together define a bi-directional helical path.
- the first thread 158 can allow for proximal translation of the shaft member 136 and the second thread 160 can allow for distal translation of the shaft member 136.
- the helical threads 132 can thereby form a bi-directional helical path for the first follower 146 and the second follower 148 to follow, thereby allowing the shaft member 136 to translate both proximally and distally along the central axis A1.
- the helical threads 132 can also define a plurality of transitional surfaces 162.
- the transitional surfaces 162 can positioned perpendicular to the central axis A1 within the helical threads 132.
- the transitional surfaces 162 can divide the helical threads 132 into a proximal portion 164 and a distal portion 166.
- the transitional surfaces 162 can generally define proximal and a distal ends of both the proximal portion 164 and the distal portion 166 of the helical threads 132.
- the first follower 146 can follow he helical threads 132 within the first portion 164.
- the second follower 148 can follow the helical threads 132 within the second portion 166.
- the transition surfaces 162 can allow the first follower 146 and the second follower 148 to transition from following the first thread 158 to following the second thread 160, and vice versa.
- the first follower 146 and the second follower 148 reach the transitional surfaces 162 at generally proximal or generally distal ends of the first portion 164 and the second portion 166 of the first thread 158, the first follower 146 and the second follower 148 can rotate within first and second recesses 150 and 152, respectively, against the transitional surfaces 162, until the first follower 146 and the second 148 follower each engage the second thread 160.
- transitional surfaces 162 can thereby allow the first follower 146 and the second follower 148 to transition from translating proximally within the first thread 158 of the housing 120, to translating distally within the second thread 160 of the housing 120, and vice versa.
- FIG. 5A illustrates a schematic view of a shaft member 136, in accordance with at least one example of the present application.
- FIG. 5B illustrates schematic views of followers 146 and 148, in accordance with at least one example of the present application. Also shown in FIGS. 5A and 5B is a central axis A1, and orientation indicators Proximal and Distal. FIGS. 5A and 5B are discussed below concurrently.
- the first follower 146 and the second follower 148 can each include a body portion 168 and a thread engaging portion 170.
- the body portion 168 can form a generally circular shape.
- the body portion 168 can also form a rectangular shape, or a variety of other three-dimensional shapes.
- the thread engaging portion 170 can extend radially outward from the body portion 168.
- the thread engaging portion 170 can form a generally semi-circular shape.
- the thread engaging portion 170 can be configured to correspond to, and engage with, the helical threads 132.
- the first recess 150 and the second recess 152 can include a central portion 172 and extended portions 174.
- the central portion 172 can be configured to correspond to and accept the body portion 168 of the first follower 146 and the second follower 148.
- the central portion 172 can also retain and position first follower 146 and the second follower 148 within first recess 150 and the second recess 152, respectively of the shaft member 136.
- the extended portions 174 of the first recess 150 and the second recess 152 can be configured to accept ends of the thread engaging portions 170 of the first follower 146 and the second follower 148.
- the extended portions 174 can be configured to provide sufficient lateral space for the ends of the thread engaging portions 170 to laterally pivot, in order prevent binding between the first follower 146, or the second follower 148, and the helical threads 132, particularly when the shaft member 136 reverses direction.
- FIG. 6 illustrates a cross-section of a reciprocating drive system positioned within a surgical instrument, in accordance with at least one example of the present application. Also shown in FIG. 6 is a central axis A1, and orientation indicators Proximal and Distal.
- the projection 154 ( FIGS. 2-3 ) can be omitted from the shaft member 136.
- the shaft member 136 can be coupled to the cutting member 110.
- the outer tube 112 can be a stationary cylindrical tube configured to accept the cutting member 110.
- the outer tube 112 can be coupled to the instrument handle 104.
- the driveshaft 117 can be coupled to the motive source 118.
- the driveshaft 117 can extend into the reciprocating drive system 100 through the drive opening 119.
- the driveshaft 117 can transfer the rotational power to the shaft member 136.
- the shaft member 136 can be configured to slide over the driveshaft 117, to allow for both transmission of rotary input to the shaft member 136, and reciprocation of the shaft member 136.
- the shaft member 136 and the cutting member 110 can rotate and reciprocate within the outer tube 112.
- the driveshaft 117 and the motive source 118 rotate the shaft member 136
- the single-directional continuous rotation provided by the motive source 118 to the shaft member 136 whether clockwise or counter-clockwise, can result in reciprocation of the shaft member 136.
- the cutting window 114 of the cutting member 110 can be driven by the shaft member 136, to reciprocate past the opening 116 of the stationary outer tube 112 to cut tissue.
- a housing can including an inner surface that defines a plurality of helical threads.
- One or more followers can engage the plurality of helical threads to drive a cutting member to cut or resect tissue.
- the simplicity of the reciprocating cutting device can decrease the cost of production, increase the reliability, and make the reciprocating cutting device suitable for disposable use to improve sterilization.
- the inclusion of a second follower can provide improved strength and cutting force over existing reciprocating cutting devices used to drive surgical cutting instruments.
- the reciprocating drive system is suitable for use in a variety of surgical procedures, including, but not limited to, open procedures, arthroscopic procedures, such as ear, nose, and throat (ENT) debridement, and keyhole procedures.
- Example 1 is a reciprocating drive system for a surgical instrument, comprising: a housing defining a central axis, the housing including: a proximal portion and an opposite distal portion; an inner surface and an outer surface, the inner surface defining a plurality of helical threads extending along the proximal portion and the distal portion of the housing; a shaft member positioned along the central axis, the shaft member including a proximal portion and an opposite distal portion, the proximal portion defining a motive coupler configured to receive torque from a motive source to rotate the shaft member; a first follower engaged with, and extending radially outward from, the shaft member and configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis; and a second follower engaged with, and extending radially outward from, the shaft member, the second follower spaced distally along the shaft member from the first follower and configured to correspondingly engage
- Example 2 the subject matter of Example 1 includes, a cutting member coupled to the distal portion of the shaft member and extending distally therefrom, the cutting member operable to cut or resect tissue when the shaft member translates laterally along the central axis.
- Example 3 the subject matter of Examples 1-2 includes, wherein the shaft member includes a first recess and a second recess, the first recess and the second recess configured to receive the first follower and the second follower, respectively, and couple the first follower and the second follower to the shaft member.
- Example 4 the subject matter of Example 3 includes, wherein the first recess is positioned at the proximal portion of the shaft member, and the second recess is positioned at the distal portion of the shaft member.
- Example 5 the subject matter of Examples 1-4 includes, wherein the housing is comprised of a first portion and a second portion, the first portion and the second portion each defining a semi-circular section of the plurality of helical threads on respective inner surfaces, the first portion and the second portion together defining the plurality of helical threads.
- Example 6 the subject matter of Examples 1-5 includes, wherein the plurality of helical threads includes a first helical thread and a second helical thread, the first helical thread defined as right-handed helical threading, and the second helical thread defined as left-handed helical threading.
- Example 7 the subject matter of Example 6 includes, wherein each thread of the first and the second helical threads intersect, such that the first follower and the second follower can transition from following the first helical thread to following the second helical thread when the first follower or the second follower reaches a proximal end, or a distal end, of the first helical thread or the second helical thread, respectively.
- Example 8 the subject matter of Examples 1-7 includes, wherein the distal portion of the shaft member includes a radial projection, the radial projection extending radially outward from the shaft member and positioned distally to the distal portion of the housing, the radial projection operable to rotate the first follower and the second follower from outside of the housing.
- Example 9 is a surgical instrument, comprising: An instrument handle having a proximal portion and a distal portion; a housing positioned within the instrument handle and defining a central axis, the housing including: a proximal portion and an opposite distal portion; an inner surface and an outer surface, the inner surface defining a plurality of helical threads extending along the proximal portion and the distal portion of the housing; a shaft member positioned along the central axis, the shaft member including a proximal portion, an opposite distal portion, and a first recess and a second recess, the proximal portion defining a motive coupler configured to receive torque from a motive source to rotate the shaft member; a first follower engaged with and extending radially outward from the first recess of the shaft member, the first follower configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis; and a cutting member coupled to
- Example 10 the subject matter of Example 9 includes, a second follower engaged with and extending radially outward from the second recess of the shaft member, the second follower spaced distally along the shaft member from the first follower and configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis.
- Example 11 the subject matter of Example 10 includes, wherein the first follower and the second follower are engaged with the shaft member in circumferentially offset positions relative to each other.
- Example 12 the subject matter of Example 11 includes, degrees relative to each other.
- Example 13 the subject matter of Examples 10-12 includes, wherein the first follower and the second follower each include a body portion and a thread engaging portion, the thread engaging portion extending radially outward from the body portion and configured to correspondingly engage the plurality of helical threads.
- Example 14 the subject matter of Example 13 includes, wherein the body portion is circular in shape.
- Example 15 the subject matter of Examples 13-14 includes, wherein the body portion is rectangular in shape.
- Example 16 the subject matter of Examples 9-15 includes, wherein the housing is comprised of a first portion and a second portion, the first portion and the second portion each defining a semi-circular section of the plurality of helical threads on respective inner surfaces, the first portion and the second portion together defining the plurality of helical threads.
- Example 17 the subject matter of Examples 9-16 includes, wherein the plurality of helical threads includes a first helical thread and a second helical thread, the first helical thread defined as right-handed helical threading, and the second helical thread defined as left-handed helical threading.
- Example 18 the subject matter of Example 17 includes, wherein each thread of the first and the second helical threads intersect, such that the first follower and the second follower can transition from following the first helical thread to following the second helical thread when the first follower or the second follower reaches a proximal end, or a distal end, of the first helical thread or the second helical thread, respectively.
- Example 19 the subject matter of Examples 9-18 includes, wherein the distal portion of the shaft member includes a radial projection, the radial projection extending radially outward from the shaft member and positioned distally to the distal portion of the housing, the radial projection operable to rotate the first follower and the second follower from outside of the housing.
- Example 20 is at least one machine-readable medium including instructions that, when executed by processing circuitry, cause the processing circuitry to perform operations to implement of any of Examples 1-19.
- Example 21 is an apparatus comprising means to implement of any of Examples 1-19.
- Example 22 is a system to implement of any of Examples 1-19.
- Example 23 is a method to implement of any of Examples 1-19.
Abstract
Description
- This application claims the benefit of priority to
U.S. Provisional Application No. 62/910,541, filed on October 4, 2019 U.S. Provisional Application No. 62/988,051, filed on March 11, 2020 - The present disclosure relates generally to cutting devices and apparatus used during surgical procedures. For example, arthroscopic, or keyhole procedures, require the use of a surgical cutting instrument that can be inserted into, and cut tissue within, a small incision relative to open procedures. Such cutting instruments utilize a reciprocating drive system to drive a variety of reciprocating or rotating cutting members to cut or resect tissue.
- In the drawings, which are not necessarily drawn to scale, like numerals may describe similar components in different views. Like numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document.
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FIG. 1A illustrates a cross-section of a reciprocating drive system positioned within a surgical instrument, in accordance with at least one example of the present application. -
FIG. 1B illustrates a schematic view of a reciprocating drive system, in accordance with at least one example of the present application. -
FIG. 2 illustrates an exploded schematic view of a reciprocating drive system, in accordance with at least one example of the present application. -
FIG. 3 illustrates a schematic view of a reciprocating drive system, in accordance with at least one example of the present application, with a portion of a housing removed to show a shaft member. -
FIG. 4 illustrates a schematic view of a housing, in accordance with at least one example of the present application. -
FIG. 5A illustrates a schematic view of a shaft member, in accordance with at least one example of the present application. -
FIG. 5B illustrates schematic views of followers, in accordance with at least one example of the present application. -
FIG. 6 illustrates a cross-section of a reciprocating drive system positioned within a surgical instrument, in accordance with at least one example of the present application. - The following description and the drawings sufficiently illustrate specific examples to enable those skilled in the art to practice them. Other examples may incorporate structural, process, or other changes. Portions and features of some examples may be included in, or substituted for, those of other examples. Examples set forth in the claims encompass all available equivalents of those claims.
- Surgical cutting instruments suitable for use in open procedures, arthroscopic procedures, ear, nose, and throat (ENT) debridement, or keyhole procedures, can utilize various types of cutting systems to cut or resect tissue. One example of a typical cutting instrument includes a cutting member comprised of a stationary outer tube and a translatable inner tube. Tissue enters an opening in the outer tube and is cut by shear force between the translatable inner tube and the stationary outer tube. Various drive systems exist to drive the cutting member. Generally, such systems include a drive member that is configured to follow a pre-formed drive path to drive the cutting member.
- However, existing drive systems typically require numerous components, which can increase the cost of production and reduce the reliability of the drive system. For example, existing systems utilize a drive path formed by a series of threads on a component separate from an external housing. Additionally, in certain situations relatively strong or dense tissue must be cut. The drive system must be robust to apply sufficient force to cut the tissue. Existing drive systems utilize a single drive member to follow the drive path. The force required can cause the single follower to break, or to skip over threads within the drive path, resulting in drive system malfunction or failure.
- The present disclosure can address these disadvantages, among others, by providing a reciprocating drive system for a surgical cutting device that can include a housing defining one or more helical threads on an inner surface. The helical threads can form a drive path for one or more followers to follow and correspondingly translate a reciprocating cutting member to cut tissue. The formation of the helical threads on the housing can reduce the number of parts required, by eliminating the need for two separate components to provide the functions of an external housing and a drive path. Reducing the number of parts required can improve the reliability and reduce the cost of production of a reciprocating drive system suitable for arthroscopic use. Additionally, the reciprocating drive system can include two or more followers to increase the force the cutting member can apply and further improve the reliability of the reciprocating drive system.
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FIG. 1A illustrates a cross-section of the reciprocatingdrive system 100 positioned within a handle of asurgical instrument 102, in accordance with at least one example of the present application.FIG. 1B illustrates a schematic view of the reciprocatingdrive system 100, in accordance with at least one example of the present application. Also shown inFIGS. 1A and 1B is a central axis A1, and orientation indicators Proximal and Distal.FIGS. 1A and 1B are discussed below concurrently. - As shown in
FIG. 1 , thereciprocating drive system 100 can be positioned within asurgical instrument 102. The reciprocatingdrive system 100 can provide reciprocating drive to thesurgical instrument 102. Thesurgical instrument 102 can be, for example, a motor-assisted arthroscopic cutting device. Thesurgical instrument 102 can also be a variety of other surgical cutting devices that utilize a reciprocating or a rotating cutting member. Thesurgical instrument 102 can include aninstrument handle 104. Theinstrument handle 104 can include aproximal portion 106 and adistal portion 108. Theproximal portion 106 and thedistal portion 108 can be proximal and distal portions, respectively, of theinstrument handle 104. The reciprocatingdrive system 100 can be positioned in various positions within theinstrument handle 104, generally between theproximal portion 106 and thedistal portion 108. - The
surgical instrument 102 can include acutting member 110 and anouter tube 112. Thecutting member 110 can be a cylindrical tube configured to be positionable and translatable within theouter tube 112. Thecutting member 110 can be coupled to, and extend distally from, the reciprocatingdrive system 100. Theouter tube 112 can be a cylindrical tube configured to accept thecutting member 110. Thecutting member 110 and theouter tube 112 can be fixedly coupled to, and extend distally from the reciprocatingdrive system 100, or theinstrument handle 104. Thecutting member 110 can include acutting window 114. The cuttingwindow 114 can be an opening formed in a generally distal potion of the cuttingmember 110. The cuttingwindow 114 can have a pair of cutting teeth. Theouter tube 112 can include anopening 116. Theopening 116 can be an opening formed in a generally distal portion of theouter tube 112. Theopening 116 can have a pair of cutting teeth. - In operation, the cutting
window 114 can be driven to reciprocate past theopening 116 to cut tissue. In one example, the cuttingmember 110 and theouter tube 112 can be reusable and fixedly coupled to theinstrument handle 104. In another example, thereciprocating drive system 100, the cuttingmember 110, theouter tube 112, or any combination thereof can be disposable and detachably coupled to theinstrument handle 104. Thereciprocating drive system 100, the cuttingmember 110, and theouter tube 112, can also be configured to be used with various existing motorized handles, such as theinstrument handle 104. When positioned within theinstrument handle 104, thereciprocating drive system 100 can be operable to translate the cuttingmember 110 proximally and distally along the central axis A1, to cut or resect tissue via reciprocating motion. - The
surgical instrument 102 can include adriveshaft 117. Thedriveshaft 117 can extend within the instrument handle 104 along the central axis A1. Thedriveshaft 117 can extend within the instrument handle 104 between theproximal portion 106 and thedistal portion 108. Thedriveshaft 117 can be coupled to thereciprocating drive system 100. Thedriveshaft 117 can extend into thereciprocating drive system 100 through adrive opening 119 formed in a generally proximal end of thereciprocating drive system 100. Thedriveshaft 117 can also be cannulated, or can otherwise define a bore extending longitudinally through thedriveshaft 117 along the central axis A1. - The instrument handle 104 can include a
motive source 118. Themotive source 118 can be, but is not limited to, an electrically or pneumatically actuated motor. Themotive source 118 can include a cannulatedshaft 121. The cannulatedshaft 121 can extend along the central axis A1, coaxially with thedriveshaft 117. The coaxial shaft configuration of thereciprocating drive system 100 and the instrument handle 104 can be simpler and more compact relative to, for example, a drive system including a vertically offset motive source. For example, some devices involving reciprocating and rotary motion utilize a three-shaft system with an offset motor in order to provide the requisite forms of motion. - A proximal portion of the cannulated
shaft 121 can be coupled to thedriveshaft 117, and a distal portion of the cannulatedshaft 121 can be coupled asuction pump 123, via asuction tube 125. Thesuction pump 123 can thereby apply suction through thesuction tube 125, the cannulatedshaft 121, and thedriveshaft 117, to facilitate transfer of fluid through thesurgical instrument 102, such as to help extract tissues or other surgical debris from thereciprocating drive system 100 or to deliver irrigation fluid. After a surgical procedure, thereciprocating drive system 100, the cuttingmember 110, and theouter tube 112 can be removed from the instrument handle 104 and discarded. This can improve the ease and quality of sterilization of thesurgical instrument 102 between surgical procedures. Thereciprocating drive system 100 can thereby help perform one or more operations of a surgical procedure. -
FIG. 2 illustrates an exploded view of thereciprocating drive system 100, in accordance with at least one example of the present application. Also shown inFIG. 2 is a central axis A1, and orientation indicators Proximal and Distal. Thereciprocating drive system 100 can include ahousing 120 having thedrive opening 119, aproximal portion 122, adistal portion 124, afirst portion 126, asecond portion 128, aninner surface 130,helical threads 132, anon-threaded portion 134, ashaft member 136, anouter surface 138,flanges 140,flange protrusions 141, flange recesses 143, aproximal portion 142, adistal portion 144, afirst follower 146, asecond follower 148, afirst recess 150, asecond recess 152, aprojection 154, and abore 156. - The
housing 120 can define a central axis A1. Theproximal portion 122 and thedistal portion 124 can be proximal and distal portions, respectively, of thehousing 120. The terms proximal and distal portion as used herein can be relative to an orientation as held by a surgeon during a surgical procedure. Thehousing 120 can be formed as single piece. Thehousing 120 can also be formed from multiple pieces. For example, thefirst portion 126 and thesecond portion 128 can be separate pieces that can together form thehousing 120. Thehousing 120 can include theinner surface 130. Theinner surface 130 can be comprised of an inner surface of both thefirst portion 126 and thesecond portion 128. Theinner surface 130 can form a generally cylindrical shape. - The
inner surface 130 can include and define thehelical threads 132. Thehelical threads 132 can extend along theinner surface 130 of thehousing 120, between theproximal portion 122 and thedistal portion 124. Theinner surface 130 of thehousing 120 can also include thenon-threaded portion 134. Thenon-threaded portion 134 can be positioned at thedistal portion 124 of thehousing 120. Thenon-threaded portion 134 can be configured to engage theshaft member 136 to position theshaft member 136 along the central axis A1, within thehousing 120. Theshaft member 136 can extend within thehousing 120 between theproximal portion 122 and thedistal portion 124. When theshaft member 136 rotates, thenon-threaded portion 134 can also function as a bearing surface for theshaft member 136. Although not described in the interest of brevity,second portion 128 can include an inner surface configured as a mirror image of theinner surface 130 such that thehelical threads 132 mate with matching helical threads to form one or more double-helical thread paths along thehousing 120. - The
housing 120 can include theouter surface 138. Theouter surface 138 can be comprised of an outer surface of both thefirst portion 126 and thesecond portion 128. Theouter surface 138 of thehousing 120 can form a generally cylindrical shape. Theouter surface 138 can also form a generally rectangular, or other three-dimensional shape. Theouter surface 138 of thehousing 120 can include theflanges 140. Theflanges 140 can be protrusions extending radially outward from generally opposite sides of theouter surface 138 ofhousing 120. Theflanges 140 can extend along theouter surface 138 of thehousing 120 between theproximal portion 122 and thedistal portion 124. Theflanges 140 on thefirst portion 126 of thehousing 120 can have different dimensions or geometries to theflanges 140 on thesecond portion 128 of thehousing 120. - For example, the
flanges 140 of thefirst portion 126 can include theflange protrusions 141, and theflanges 140 of thesecond portion 128 can include the flange recesses 143. The flange protrusions 141 can be configured to engage the flange recesses 143, to couple thefirst portion 126 of thehousing 120 to thesecond portion 128 of thehousing 120. Theflanges 140 can thereby allow thefirst portion 126 and thesecond portion 128 to resists separation due to rotational, lateral, or other operational forces generated during use. Additionally, when thereciprocating drive system 100 is positioned within a surgical instrument, theflanges 140 can help to orient and position thehousing 120 within the surgical instrument. - The
proximal portion 142 and thedistal portion 144 can be proximal and distal portions, respectively, of theshaft member 136. Theproximal portion 142 of theshaft member 136 can extend within theproximal portion 122 of thehousing 120. Thedistal portion 144 of theshaft member 136 can extend within thedistal portion 124 of thehousing 120. Thedistal portion 144 of theshaft member 136 can also extend distally beyond thedistal portion 124 of thehousing 120. Theshaft member 136 can include thefirst follower 146. Theshaft member 136 can also optionally include thesecond follower 148. Thefirst follower 146 and thesecond follower 148 can extend radially outward from theshaft member 136. Thefirst follower 146 and thesecond follower 148 can be positioned in various orientations along theshaft member 136. Thefirst follower 146 and thesecond follower 148 can be shaped to correspond to thehelical threads 132 formed in thehousing 120. Thefirst follower 146 and thesecond follower 148 can be configured to correspondingly engage and follow thehelical threads 132. Optionally, thefirst follower 146 and thesecond follower 148 can be interchangeable to reduce the number of different parts needed for manufacture of thereciprocating drive system 100. - The
shaft member 136 can include thefirst recess 150 and thesecond recess 152. Thefirst recess 150 and thesecond recess 152 can be formed in theshaft member 136. Thefirst recess 150 and thesecond recess 152 can be configured to accept and retain thefirst follower 146 and thesecond follower 148, respectively. Thefirst recess 150 and thefirst follower 146 can be sufficiently similar in shape and size to thesecond recess 152 and thesecond follower 148, to allow thefirst follower 146 to be positioned within thesecond recess 152, and thesecond follower 148 to be positioned within thefirst recess 150. When theshaft member 136 is positioned within thehousing 120, thefirst recess 150 and thesecond recess 152 can be configured to position thefirst follower 146 and thesecond follower 148 to engage thehelical threads 132. Thefirst recess 150 and thesecond recess 152 can thereby help to maintain alignment of theshaft member 136 with the central axis A1 when theshaft member 136 rotates. - In some examples, the
shaft member 136 can include theprojection 154. Theprojection 154 can extend radially outward from thedistal portion 144 of theshaft member 136. Theprojection 154 can be positioned distally to thedistal portion 124 of thehousing 120. Theprojection 154 can extend radially outward beyond an external width, or a height, of thedistal portion 124 of thehousing 120. Theprojection 154 can be coupled to or formed on thedistal portion 144 of theshaft member 136, in a position sufficiently distal to thehousing 120, to allow theprojection 154 to rotate and reciprocate proximally and distally along the central axis A1, when theshaft member 136 rotates. Theprojection 154 can thereby provide convenient access to thedistal portion 144 of theshaft member 136 to manually apply rotational, and correspondingly, reciprocating movement to theshaft member 136, when at least theproximal portion 142 ofshaft member 136 is disposed within thehousing 120. - The
shaft member 136 can include thebore 156. Thebore 156 can extend within theshaft member 136 between theproximal portion 142 and thedistal portion 144. Thebore 156 can be configured to accept and engage a driveshaft, such as thedriveshaft 117 shown inFIG. 1 . Thedriveshaft 117 can extend through thedrive opening 119 formed in thesecond portion 128 of thehousing 120, to engage thebore 156 of theshaft member 136. Thebore 156 can function as a motive coupler when engaging a driveshaft coupled to a motive source, such as thedriveshaft 117. - The
housing 120, theproximal portion 122, thedistal portion 124, thefirst portion 126, thesecond portion 128, theinner surface 130, thehelical threads 132, thenon-threaded portion 134, theshaft member 136, theouter surface 138, theflanges 140, theproximal portion 142, thedistal portion 144, thefirst follower 146, thesecond follower 148, thefirst recess 150, thesecond recess 152, theprojection 154, and thebore 156 can each be made from, but not limited to, plastic. For example, the components listed above can be made from ABS plastic. Thehousing 120, theproximal portion 122, thedistal portion 124, thefirst portion 126, thesecond portion 128, theinner surface 130, thehelical threads 132, thenon-threaded portion 134, theshaft member 136, theouter surface 138, theflanges 140, theproximal portion 142, thedistal portion 144, thefirst follower 146, thesecond follower 148, thefirst recess 150, thesecond recess 152, theprojection 154, and thebore 156 can also be made from stainless steel, or other metals via machining or metallic molding. - As discussed with reference to
FIG. 3 , when the driveshaft 117 (FIG. 1 ) and the motive source 118 (FIG. 1 ) rotate theshaft member 136, thefirst follower 146 and thesecond follower 148 can be driven proximally and distally along thehelical threads 132 to thereby reciprocate theshaft member 136, while thehousing 120 is held in a stationary position within the instrument handle 104 (FIG. 1 ) by theflanges 140. The single-directional continuous rotation provided by themotive source 118 to theshaft member 136, whether clockwise or counter-clockwise, can result in reciprocation of theshaft member 136. - The
shaft member 136 can be configured to slide over thedriveshaft 117 to allow for both transmission of rotary input to theshaft member 136, and reciprocation of theshaft member 136. However, the transmission of rotary input to theshaft member 136, and associated reciprocation of the cuttingmember 110, with or without rotation, can be achieved using a variety of arrangements including couplers, bearings, clutches and the like. For example, thedriveshaft 117 can include a male key or male splines configured to mate into a female key or female splines formed in theshaft member 136, to transfer rotary input from thedriveshaft 117 to theshaft member 136 while allowing reciprocation along the central axis A1, within a longitudinal length of the key or the splines. -
FIG. 3 illustrates a schematic view of thereciprocating drive system 100, in accordance with at least one example of the present application. Also shown inFIG. 3 is a central axis A1, and orientation indicators Proximal and Distal. - The
first follower 146 can be positioned within and extend radially outward from thefirst recess 150 of theshaft member 136. Thesecond follower 148 can engage and extend radially outward from thesecond recess 152 of theshaft member 136. Thefirst follower 146 and thesecond follower 148 can be configured to correspondingly engage thehelical threads 132. When theshaft member 136 rotates, thefirst follower 146 and thesecond follower 148 can follow thehelical threads 132 to laterally translate theshaft member 136 along the central axis A1. Theshaft member 136 can receive and transfer torque from a motive source to rotate theshaft member 136 within thehousing 120. In some examples, the reciprocating cutting system can include theprojection 154. Theprojection 154 can allow a user to manually rotate theshaft member 136 from a position external to thehousing 120, to manually reciprocate theshaft member 136 proximally and distally along the central axis A1. - The
first follower 146 and thefirst recess 150 can be laterally spaced apart from thesecond follower 148 and thesecond recess 152 along theshaft member 136. For example, thefirst follower 146 and thefirst recess 150 can be positioned at theproximal portion 142 of theshaft member 136 and thesecond follower 148 and thesecond recess 152 can be centrally located on theshaft member 136, generally halfway between theproximal portion 142 and thedistal portion 144. Thefirst recess 150 and thesecond recess 152 can be formed in various other positions on theshaft member 136 generally between theproximal portion 142 and thedistal portion 144. The position of thefirst recess 150 and thesecond recess 152, and correspondingly, thefirst follower 146 and thesecond follower 148, can dictate the distance theshaft member 136 travels laterally within thehousing 120. The stroke length of a reciprocating cutting member can thereby be optimized for various surgical procedures based upon the lateral positioning of thefirst recess 150 and thesecond recess 152 on theshaft member 136. - Additionally, the
first recess 150 and thesecond recess 152 can be formed circumferentially offset positions relative to each other on theshaft member 136. For example, thesecond recess 152 can be positioned 180 degrees offset relative to thefirst recess 150. Thesecond recess 152 can also be offset, 45, 90, 135, 225, or 270 degrees offset relative to thefirst recess 150. The circumferential offset of thefirst follower 146 relative to thesecond follower 148 can improve the axial alignment of theshaft member 136 within thenon-threaded portion 134 of thehousing 120 to prevent binding of thefirst follower 146 and thesecond follower 148 within thehelical threads 132. The circumferential offset of thefirst follower 146 relative to thesecond follower 148 can thereby provide smoother operation of thereciprocating drive system 100, particularly when dense or tough tissues are to be cut. - The
helical threads 132 can define a bi-directional helical path for thefirst follower 146 and thesecond follower 148 to follow. In operation, when either thefirst follower 146 or thesecond follower 148 reaches a proximal or a distal end of thehelical threads 132, the first 146 or the second 148 followers can reverse direction and follow thehelical threads 132 back in the opposite direction. Thehelical threads 132 can thereby allow theshaft member 136 to reciprocate through cyclical proximal and distal translation when theshaft member 136 rotates either clockwise or counterclockwise. As discussed with reference toFIG. 4 , thehelical threads 132 can provide two separate thread paths for thefirst follower 146 and thesecond follower 148 to follow, respectively. -
FIG. 4 illustrates a schematic view of thehousing 120, in accordance with at least one example of the present application. Also shown inFIG. 4 is a central axis A1, and orientation indicators Proximal and Distal. Thereciprocating cutting device 100 can include a first series ofthreads 158, a second series of threads, andtransitional surfaces 162. - As shown in
FIG. 4 , thehelical threads 132 can extend along theinner surface 130 of thehousing 120, generally from between theproximal portion 122 and thenon-threaded portion 134 at thedistal portion 124. A portion of theinner surface 130 of the housing at theproximal portion 122 can also be non-threaded. Thehelical threads 132 can define a single directional helical path or a bi-directional helical path. Thehelical threads 132 can include afirst thread 158 and asecond thread 160. - The
first thread 158 can be a first helical thread formed at a first orientation on theinner surface 130 of thehousing 120. Thesecond thread 160 can be a second thread formed at a second orientation on theinner surface 130 of thehousing 120. Thesecond thread 160 can be formed at different orientation relative to thefirst thread 158. For example, thefirst thread 158 can be a right-handed thread and thesecond thread 160 can be a left-handed thread, or vice versa. As a result, thefirst thread 158 and thesecond thread 160 can intersect to together define a bi-directional helical path. For example, thefirst thread 158 can allow for proximal translation of theshaft member 136 and thesecond thread 160 can allow for distal translation of theshaft member 136. Thehelical threads 132 can thereby form a bi-directional helical path for thefirst follower 146 and thesecond follower 148 to follow, thereby allowing theshaft member 136 to translate both proximally and distally along the central axis A1. - The
helical threads 132 can also define a plurality oftransitional surfaces 162. Thetransitional surfaces 162 can positioned perpendicular to the central axis A1 within thehelical threads 132. Thetransitional surfaces 162 can divide thehelical threads 132 into aproximal portion 164 and adistal portion 166. Thetransitional surfaces 162 can generally define proximal and a distal ends of both theproximal portion 164 and thedistal portion 166 of thehelical threads 132. Thefirst follower 146 can follow hehelical threads 132 within thefirst portion 164. Thesecond follower 148 can follow thehelical threads 132 within thesecond portion 166. - In operation, the transition surfaces 162 can allow the
first follower 146 and thesecond follower 148 to transition from following thefirst thread 158 to following thesecond thread 160, and vice versa. For example, when thefirst follower 146 and thesecond follower 148 reach thetransitional surfaces 162 at generally proximal or generally distal ends of thefirst portion 164 and thesecond portion 166 of thefirst thread 158, thefirst follower 146 and thesecond follower 148 can rotate within first andsecond recesses transitional surfaces 162, until thefirst follower 146 and the second 148 follower each engage thesecond thread 160. Accordingly, thetransitional surfaces 162 can thereby allow thefirst follower 146 and thesecond follower 148 to transition from translating proximally within thefirst thread 158 of thehousing 120, to translating distally within thesecond thread 160 of thehousing 120, and vice versa. -
FIG. 5A illustrates a schematic view of ashaft member 136, in accordance with at least one example of the present application.FIG. 5B illustrates schematic views offollowers FIGS. 5A and 5B is a central axis A1, and orientation indicators Proximal and Distal.FIGS. 5A and 5B are discussed below concurrently. - The
first follower 146 and thesecond follower 148 can each include abody portion 168 and athread engaging portion 170. Thebody portion 168 can form a generally circular shape. Thebody portion 168 can also form a rectangular shape, or a variety of other three-dimensional shapes. Thethread engaging portion 170 can extend radially outward from thebody portion 168. Thethread engaging portion 170 can form a generally semi-circular shape. Thethread engaging portion 170 can be configured to correspond to, and engage with, thehelical threads 132. - The
first recess 150 and thesecond recess 152 can include acentral portion 172 andextended portions 174. Thecentral portion 172 can be configured to correspond to and accept thebody portion 168 of thefirst follower 146 and thesecond follower 148. Thecentral portion 172 can also retain and positionfirst follower 146 and thesecond follower 148 withinfirst recess 150 and thesecond recess 152, respectively of theshaft member 136. Theextended portions 174 of thefirst recess 150 and thesecond recess 152 can be configured to accept ends of thethread engaging portions 170 of thefirst follower 146 and thesecond follower 148. Theextended portions 174 can be configured to provide sufficient lateral space for the ends of thethread engaging portions 170 to laterally pivot, in order prevent binding between thefirst follower 146, or thesecond follower 148, and thehelical threads 132, particularly when theshaft member 136 reverses direction. -
FIG. 6 illustrates a cross-section of a reciprocating drive system positioned within a surgical instrument, in accordance with at least one example of the present application. Also shown inFIG. 6 is a central axis A1, and orientation indicators Proximal and Distal. - As shown in
FIG. 6 , the projection 154 (FIGS. 2-3 ) can be omitted from theshaft member 136. Theshaft member 136 can be coupled to the cuttingmember 110. Theouter tube 112 can be a stationary cylindrical tube configured to accept the cuttingmember 110. Theouter tube 112 can be coupled to theinstrument handle 104. Thedriveshaft 117 can be coupled to themotive source 118. Thedriveshaft 117 can extend into thereciprocating drive system 100 through thedrive opening 119. Thedriveshaft 117 can transfer the rotational power to theshaft member 136. - The
shaft member 136 can be configured to slide over thedriveshaft 117, to allow for both transmission of rotary input to theshaft member 136, and reciprocation of theshaft member 136. Theshaft member 136 and the cuttingmember 110 can rotate and reciprocate within theouter tube 112. When thedriveshaft 117 and themotive source 118 rotate theshaft member 136, the single-directional continuous rotation provided by themotive source 118 to theshaft member 136, whether clockwise or counter-clockwise, can result in reciprocation of theshaft member 136. Accordingly, the cuttingwindow 114 of the cuttingmember 110 can be driven by theshaft member 136, to reciprocate past theopening 116 of the stationaryouter tube 112 to cut tissue. - The devices and methods discussed herein provide the benefits of, among others, a simplified reciprocating drive system for use with a motorized surgical cutting instrument. A housing can including an inner surface that defines a plurality of helical threads. One or more followers can engage the plurality of helical threads to drive a cutting member to cut or resect tissue. The simplicity of the reciprocating cutting device can decrease the cost of production, increase the reliability, and make the reciprocating cutting device suitable for disposable use to improve sterilization. Additionally, the inclusion of a second follower can provide improved strength and cutting force over existing reciprocating cutting devices used to drive surgical cutting instruments. The reciprocating drive system is suitable for use in a variety of surgical procedures, including, but not limited to, open procedures, arthroscopic procedures, such as ear, nose, and throat (ENT) debridement, and keyhole procedures.
- The following, non-limiting examples, detail certain aspects of the present subject matter to solve the challenges and provide the benefits discussed herein, among others.
- Example 1 is a reciprocating drive system for a surgical instrument, comprising: a housing defining a central axis, the housing including: a proximal portion and an opposite distal portion; an inner surface and an outer surface, the inner surface defining a plurality of helical threads extending along the proximal portion and the distal portion of the housing; a shaft member positioned along the central axis, the shaft member including a proximal portion and an opposite distal portion, the proximal portion defining a motive coupler configured to receive torque from a motive source to rotate the shaft member; a first follower engaged with, and extending radially outward from, the shaft member and configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis; and a second follower engaged with, and extending radially outward from, the shaft member, the second follower spaced distally along the shaft member from the first follower and configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis.
- In Example 2, the subject matter of Example 1 includes, a cutting member coupled to the distal portion of the shaft member and extending distally therefrom, the cutting member operable to cut or resect tissue when the shaft member translates laterally along the central axis.
- In Example 3, the subject matter of Examples 1-2 includes, wherein the shaft member includes a first recess and a second recess, the first recess and the second recess configured to receive the first follower and the second follower, respectively, and couple the first follower and the second follower to the shaft member.
- In Example 4, the subject matter of Example 3 includes, wherein the first recess is positioned at the proximal portion of the shaft member, and the second recess is positioned at the distal portion of the shaft member.
- In Example 5, the subject matter of Examples 1-4 includes, wherein the housing is comprised of a first portion and a second portion, the first portion and the second portion each defining a semi-circular section of the plurality of helical threads on respective inner surfaces, the first portion and the second portion together defining the plurality of helical threads.
- In Example 6, the subject matter of Examples 1-5 includes, wherein the plurality of helical threads includes a first helical thread and a second helical thread, the first helical thread defined as right-handed helical threading, and the second helical thread defined as left-handed helical threading.
- In Example 7, the subject matter of Example 6 includes, wherein each thread of the first and the second helical threads intersect, such that the first follower and the second follower can transition from following the first helical thread to following the second helical thread when the first follower or the second follower reaches a proximal end, or a distal end, of the first helical thread or the second helical thread, respectively.
- In Example 8, the subject matter of Examples 1-7 includes, wherein the distal portion of the shaft member includes a radial projection, the radial projection extending radially outward from the shaft member and positioned distally to the distal portion of the housing, the radial projection operable to rotate the first follower and the second follower from outside of the housing.
- Example 9 is a surgical instrument, comprising: An instrument handle having a proximal portion and a distal portion; a housing positioned within the instrument handle and defining a central axis, the housing including: a proximal portion and an opposite distal portion; an inner surface and an outer surface, the inner surface defining a plurality of helical threads extending along the proximal portion and the distal portion of the housing; a shaft member positioned along the central axis, the shaft member including a proximal portion, an opposite distal portion, and a first recess and a second recess, the proximal portion defining a motive coupler configured to receive torque from a motive source to rotate the shaft member; a first follower engaged with and extending radially outward from the first recess of the shaft member, the first follower configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis; and a cutting member coupled to and extending distally beyond the distal portion of the instrument handle from the distal portion of the shaft member, the cutting member operable to cut or resect tissue when the shaft member translates along the central axis.
- In Example 10, the subject matter of Example 9 includes, a second follower engaged with and extending radially outward from the second recess of the shaft member, the second follower spaced distally along the shaft member from the first follower and configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis.
- In Example 11, the subject matter of Example 10 includes, wherein the first follower and the second follower are engaged with the shaft member in circumferentially offset positions relative to each other.
- In Example 12, the subject matter of Example 11 includes, degrees relative to each other.
- In Example 13, the subject matter of Examples 10-12 includes, wherein the first follower and the second follower each include a body portion and a thread engaging portion, the thread engaging portion extending radially outward from the body portion and configured to correspondingly engage the plurality of helical threads.
- In Example 14, the subject matter of Example 13 includes, wherein the body portion is circular in shape.
- In Example 15, the subject matter of Examples 13-14 includes, wherein the body portion is rectangular in shape.
- In Example 16, the subject matter of Examples 9-15 includes, wherein the housing is comprised of a first portion and a second portion, the first portion and the second portion each defining a semi-circular section of the plurality of helical threads on respective inner surfaces, the first portion and the second portion together defining the plurality of helical threads.
- In Example 17, the subject matter of Examples 9-16 includes, wherein the plurality of helical threads includes a first helical thread and a second helical thread, the first helical thread defined as right-handed helical threading, and the second helical thread defined as left-handed helical threading.
- In Example 18, the subject matter of Example 17 includes, wherein each thread of the first and the second helical threads intersect, such that the first follower and the second follower can transition from following the first helical thread to following the second helical thread when the first follower or the second follower reaches a proximal end, or a distal end, of the first helical thread or the second helical thread, respectively.
- In Example 19, the subject matter of Examples 9-18 includes, wherein the distal portion of the shaft member includes a radial projection, the radial projection extending radially outward from the shaft member and positioned distally to the distal portion of the housing, the radial projection operable to rotate the first follower and the second follower from outside of the housing.
- Example 20 is at least one machine-readable medium including instructions that, when executed by processing circuitry, cause the processing circuitry to perform operations to implement of any of Examples 1-19.
- Example 21 is an apparatus comprising means to implement of any of Examples 1-19.
- Example 22 is a system to implement of any of Examples 1-19.
- Example 23 is a method to implement of any of Examples 1-19.
Claims (19)
- A reciprocating drive system for a surgical instrument, comprising:a housing defining a central axis, the housing including:a proximal portion and an opposite distal portion;an inner surface and an outer surface, the inner surface defining a plurality of helical threads extending along the proximal portion and the distal portion of the housing;a shaft member positioned along the central axis, the shaft member including a proximal portion and an opposite distal portion, the proximal portion or the distal portion of the shaft member defining a motive coupler configured to receive torque from a motive source to rotate the shaft member;a first follower engaged with, and extending radially outward from, the shaft member and configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis; anda second follower engaged with, and extending radially outward from, the shaft member, the second follower spaced distally along the shaft member from the first follower and configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis.
- The reciprocating drive system of claim 1, further comprising a cutting member coupled to the distal portion of the shaft member and extending distally therefrom, the cutting member operable to cut or resect tissue when the shaft member translates laterally along the central axis.
- The reciprocating drive system of claim 1 or 2, wherein the shaft member includes a first recess and a second recess, the first recess and the second recess configured to receive the first follower and the second follower, respectively, and couple the first follower and the second follower to the shaft member.
- The reciprocating drive system of claim 3, wherein the first recess is positioned at the proximal portion of the shaft member, and the second recess is positioned at the distal portion of the shaft member, or at a place between the proximal portion and the distal portion.
- The reciprocating drive system of any of claims 1 to 4, wherein the housing is comprised of a first portion and a second portion, the first portion and the second portion each defining a semi-circular section of the plurality of helical threads on respective inner surfaces, the first portion and the second portion together defining the plurality of helical threads.
- The reciprocating drive system of any of claims 1 to 5, wherein the plurality of helical threads includes a first helical thread and a second helical thread, the first helical thread defined as right-handed helical threading, and the second helical thread defined as left-handed helical threading.
- The reciprocating drive system of claim 6, wherein each thread of the first and the second helical threads intersect, such that the first follower and the second follower can transition from following the first helical thread to following the second helical thread when the first follower or the second follower reaches a proximal end, or a distal end, of the first helical thread or the second helical thread, respectively.
- The reciprocating drive system of any of claims 1 to 7, wherein the distal portion of the shaft member includes a radial projection, the radial projection extending radially outward from the shaft member and positioned distally to the distal portion of the housing, the radial projection operable to rotate the first follower and the second follower from outside of the housing.
- A surgical instrument, comprising:an instrument handle having a proximal portion and a distal portion;a housing positioned within the instrument handle and defining a central axis, the housing including:a proximal portion and an opposite distal portion;an inner surface and an outer surface, the inner surface defining a plurality of helical threads extending along the proximal portion and the distal portion of the housing;a shaft member positioned along the central axis, the shaft member including a proximal portion, an opposite distal portion, and a first recess and a second recess, the proximal portion defining a motive coupler configured to receive torque from a motive source to rotate the shaft member;a first follower engaged with and extending radially outward from the first recess of the shaft member, the first follower configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis; anda cutting member coupled to and extending distally beyond the distal portion of the instrument handle from the distal portion of the shaft member, the cutting member operable to cut or resect tissue when the shaft member translates along the central axis.
- The surgical instrument of claim 9, further comprising a second follower engaged with and extending radially outward from the second recess of the shaft member, the second follower spaced distally along the shaft member from the first follower and configured to correspondingly engage the plurality of helical threads such that rotation of the shaft member translates the shaft member laterally along the central axis.
- The surgical instrument of claim 10, wherein the first follower and the second follower are engaged with the shaft member in circumferentially offset positions relative to each other.
- The surgical instrument of claim 11, wherein the first follower and the second follower are circumferentially offset by 180 degrees relative to each other.
- The surgical instrument of any of claims 10 to 12, wherein the first follower and the second follower each include a body portion and a thread engaging portion, the thread engaging portion extending radially outward from the body portion and configured to correspondingly engage the plurality of helical threads.
- The surgical instrument of claim 13, wherein the body portion is circular in shape.
- The surgical instrument of claim 13, wherein the body portion is rectangular in shape.
- The surgical instrument of any of claims 9 to 15, wherein the housing is comprised of a first portion and a second portion, the first portion and the second portion each defining a semi-circular section of the plurality of helical threads on respective inner surfaces, the first portion and the second portion together defining the plurality of helical threads.
- The reciprocating drive system of any of claims 9 to 16, wherein the plurality of helical threads includes a first helical thread and a second helical thread, the first helical thread defined as right-handed helical threading, and the second helical thread defined as left-handed helical threading.
- The surgical instrument of claim 17, wherein each thread of the first and the second helical threads intersect, such that the first follower and the second follower can transition from following the first helical thread to following the second helical thread when the first follower or the second follower reaches a proximal end, or a distal end, of the first helical thread or the second helical thread, respectively.
- The surgical instrument of any of claims 9 to 18, wherein the distal portion of the shaft member includes a radial projection, the radial projection extending radially outward from the shaft member and positioned distally to the distal portion of the housing, the radial projection operable to rotate the first follower and the second follower from outside of the housing.
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Application Number | Priority Date | Filing Date | Title |
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US201962910541P | 2019-10-04 | 2019-10-04 | |
US202062988051P | 2020-03-11 | 2020-03-11 |
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EP3799809A1 true EP3799809A1 (en) | 2021-04-07 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP20199924.0A Withdrawn EP3799809A1 (en) | 2019-10-04 | 2020-10-02 | Reciprocating drive system for a cutting device |
Country Status (2)
Country | Link |
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US (1) | US11389187B2 (en) |
EP (1) | EP3799809A1 (en) |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4316465A (en) * | 1979-03-30 | 1982-02-23 | Dotson Robert S Jun | Ophthalmic handpiece with pneumatically operated cutter |
US8006578B2 (en) * | 2005-10-12 | 2011-08-30 | Kiester Douglas P | Apparatus and method for a high speed rotation-to-rotation oscillation converter for surgical use |
EP3403602A1 (en) * | 2017-05-16 | 2018-11-21 | Biosense Webster (Israel) Ltd. | Deflectable shaver tool |
Family Cites Families (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10363066B2 (en) * | 2017-07-21 | 2019-07-30 | Gyrus Acmi, Inc. | Tissue resection device |
-
2020
- 2020-09-30 US US17/039,199 patent/US11389187B2/en active Active
- 2020-10-02 EP EP20199924.0A patent/EP3799809A1/en not_active Withdrawn
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4316465A (en) * | 1979-03-30 | 1982-02-23 | Dotson Robert S Jun | Ophthalmic handpiece with pneumatically operated cutter |
US8006578B2 (en) * | 2005-10-12 | 2011-08-30 | Kiester Douglas P | Apparatus and method for a high speed rotation-to-rotation oscillation converter for surgical use |
EP3403602A1 (en) * | 2017-05-16 | 2018-11-21 | Biosense Webster (Israel) Ltd. | Deflectable shaver tool |
Also Published As
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US20210100575A1 (en) | 2021-04-08 |
US11389187B2 (en) | 2022-07-19 |
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